Abstract: :
Purpose: To describe the angiographic and clinical featuresof 27 eyes at baseline which either had, or went on to develop,RAP during the course of the TTT4CNV study. This prospectivestudy had 303 patients with small (<3mm diameter lesion)occult (<10% classic) subfoveal choroidal neovascular membranesat baseline, treated with either transpupillary thermotherapy(TTT) or sham therapy. Presence or absence of RAP features didnot influence selection.Methods: 288 eyes in the TTT4CNV study were re–gradedto document the presence or absence of eight photographic and/orangiographic features that may be associated with RAP. In allcases, stereoscopic color and red–free fundus photos andstereo fluorescein angiograms were used for evaluation. Featuresevaluated include those documented by Slakter and Yannuzzi etal1 as being characteristically associated with RAP, as wellas reticular pseudo–drusen, a feature not previously associatedwith RAP. 20 eyes had 24 months of follow–up, 5 had 12months follow–up, and two had 6 months follow–up.Results:27 eyes with gradeable photos and angiograms eitherhad RAP at baseline or developed it during the study. Baselinefeatures include: 26 of 27 (96%) of eyes had superficial retinalhemorrhages; 9 had a classic component to their CNV (33%), 12had an angiographic "hot spot" (44%), 8 had a retinal–lesionanastomosis (30%), 6 had a serous pigment epithelial detachment(22%), 21 had lipid exudates (78%), 8 had a fibrovascular PED(30%), and 9 had reticular pseudo–drusen (33%). The oneeye without definite superficial hemorrhage at baseline diddemonstrate intraretinal blood at the three–month visit.Conclusions: Superficial retinal hemorrhages were a near–constantfeature in eyes which developed or were to develop RAP. Activeexudation, as evidenced by intra–retinal lipid, was afeature in three–fourths of the eyes. A surprising associationwas reticular pseudo–drusen, a rare lesion which was anassociated feature in eyes with RAP in a third of the cases. 1. Slakter JS, Yannuzzi LA et al. Retinal choroidal anastomosesand occult choroidal neovascularization in age–relatedmacular degeneration. Ophthalmol 2000;107:742–753